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Assessment and Diagnosis Nr443 Community Health Nursing

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Assessment and Diagnosis
Kimberly Bowen
NR443 Community Health Nursing

Ellsworth Wisconsin in Pierce County is a smaller community of mostly farming, nestled in Northwestern Wisconsin it consist of 250 square miles. According to Wisconsin Department of Health Services (2013). Pierce County residents are among the healthiest in the state, according to the 2013 County Health Rankings released by the University of Wisconsin Population Health Institute (UWPHI) and the Robert Wood Johnson Foundation (RWJF). And Pierce County ranks in the top quartile for health outcomes and health factors. Pierce County ranks in the top quartile of Wisconsin counties for health behaviors and social and economic factors. Pierce County ranks in the top half of Wisconsin counties for clinical care but in the bottom half for physical environment, the physical environment that is going to be explored is water quality and the effects on this community.
Ellsworth is a village in Pierce County, in the Minneapolis-Saint Paul metro area. It is the county seat. The community was named after Col. Elmer E. Ellsworth, killed in Virginia during the Civil War. The latitude of Ellsworth is 44.732N. The longitude is -92.487W. It is in the Central Standard time zone. Elevation is 1,214 feet (E Podunk, 2013), Col. Ellsworth became well known for his military tact’s and that is how the town got his name as a town, it was to honor him for his serves. Ellsworth is a small Ellsworth is 96.6 % predominately Caucasian, the Median age is 37.5 years of age. The largest industry in this town is agriculture, feed mills, cooperative creamery and farm supply stores. There are two farming implement dealers for the buying and having equipment worked on. There are three fast food restaurants and 4 family restaurants, 4 gas stations, two clinics, and one grocery store, there country elementary schools, one middle school and one high school right in town. This community is tight, if you have lived here for long you know just about everyone, if you have children in the school district. There are no community colleges or university in this town but are a 7 to choose from within a 40 mile radius of Ellsworth. The Hospitals are 10 and 15 miles away and there are several specialty hospitals with in an hour and a half from the town. This community has a very low rate of crimes with zero murders, Rapes and robberies in the year 2011, this community is at 188.6 for a crime rate and the national average is 391.1. Over all it is a safe community, (City-Data, 2011). Pierce County is the 21st fastest growing county in Wisconsin (E Podunk, 2013). The average age for Wisconsin to live is 80.2 years and 78.9 years is the national life expectancy; health statistics for Wisconsin was interesting to see that people that are obese, diabetic, or no physical activity is that the days missed from work is on an average two to three times more than of those who do not. 57% of Wisconsin residents reported that they are in excellent health and 35 % reported that they do not get proper sleep, according to Wisconsin department of health services (2012).
According to Wisconsin Epidemiological Profile (2008) the prevalence of current alcohol use among adults and high school students in Wisconsin has been consistently high. Current alcohol use was reported by 69% of Wisconsin adults (age 18 and older) in 2006 and 49% of Wisconsin high school students in 2007, and in 2007, nearly half (49%) of Wisconsin high school students reported current alcohol use (at least one drink in the past 30 days). This was higher than the United States rate (45%).
Revise, The report finds that between 2001 and 2010 there were over 8 million marijuana arrests in theUnited States, 88% of which were for possession. Marijuana arrests have increased between 2001 and 2010 and now account for over half (52%) of all drug arrests in the
United States, and marijuana possession arrests account for nearly half (46%) of all drug arrests. In 2010, there was one marijuana arrest every 37 seconds, and states spent combined over $3.6 billion enforcing marijuana possession laws. According to American Civil Liberties Union (2013). According to the state of Wisconsin 18.9% of teens use marijuana and verses the national average of 20.8. In Ellsworth on can smell marijuana when walking to school from teens smoking it in their cars.
Historical signficants The main source of nitrate pollution in the groundwater results from the actions of farmers. "Farming alone pollutes more of our groundwater resources than anything else. Because too many farmers are caught up in an escalating cycle of pollution" (Behm, 1989, p. 2). The farmers first deplete the soil by "excessive, repeat planting" and then try to replenish the resulting less-productive soil by putting more and more nitrogen-based fertilizer on the land in an attempt to keep crop yields constant.
One example of proof that farming is a major cause of groundwater pollution is that nitrate problems are most common in the spring, which is the time that farmers apply nitrogen fertilizer to their fields. Also, in a study done by Burkart and Kolpin (1993) it is found that samples of water from wells surrounded by more than 25% land in corn and soybean have a dramatically larger frequency of excess nitrate (30%) than wells with approximately 25% of the surrounding land in corn or soybean (11%) . Also many of the same factors that effect nitrogen leaching in turfgrass affect it in crop fields. For example, the use of irrigation increases the chance of nitrate pollution. "The frequency of excess nitrate was also larger where irrigation was used within 3.2 km of a well (41%) than where no irrigation was used (24%)" (Burkart and Kolpin, 1993, p. 654). In areas where "the soils over the aquifer are predominantly sand, sorption of herbicides is limited and the rate of recharge is rapid, resulting in a relatively large potential for contamination of aquifers with ... nitrates" (Burkart and Kolpin, 1993, p. 654).
Alpha resorce http://www.reopure.com/nitratinfo.html

Scholarly Sources:
Behm, D,( 1989), Ill Waters: The Fouling of Wisconsin's Lakes and Streams (Special Report), The Milwaukee Journal, p. 2. http://www.gjournals.org/GJEPH/GJEPH%20PDF/2013/April/Eltigani%20and%20Abdallaziz.pdf

RADON
Radon is an odorless, invisible radioactive gas that come from trace amounts of uranium occurring naturally in the ground. The gas can get into a house through the foundation and breathing air with high levels of radon can lead to lung cancer. Between 5-10% of homes in Wisconsin have radon levels above the US EPA guideline of 4pCi/L. The only way to know the radon level in your home is to measure it.
Radon test kits are available in our office.

For more information on Radon in Wisconsin, the health effects of Radon, a list of certified radon contractors in Wisconsin and other Radon information, click on the following links. http://www.epa.gov/radon MOLD
Indoors, molds live in areas of high humidity, such as basements and poorly ventilated bathrooms. To grow and multiply, mold requires moisture, nutrients and suitable material on which to establish. Of these conditions, controlling excess moisture is the key to preventing and stopping indoor mold growth. http://www.dhs.wisconsin.gov/eh/mold/ http://www.cdc.gov/mold
If you have questions or concerns about mold in your home, contact us for additional information.
CARBON MONOXIDE
Carbon monoxide is the most common cause of fatal poisoning in Wisconsin. Carbon monoxide is an odorless, colorless gas. It is formed during incomplete burning of fuels, such as gasoline, kerosene, natural gas, oil, coal or wood. In homes, carbon monoxide can quickly build up from a poorly ventilated or malfunctioning heater, furnace, range or any fuel-powered appliance, or even from a vehicle left idling in a garage.
The early warning signs of carbon monoxide are drowsiness, headache, nausea or dizziness; which are easily mistaken for the flu. When exposure occurs during sleep or in cases of very high CO levels, unconsciousness and death may occur quickly with no warning symptoms. www.dhs.wisconsin.gov/eh/air/fs/co.htm www.cdc.gov/co/
Wisconsin State Law now requires carbon monoxide (CO) detectors in all residences in Wisconsin.

References University of Wisconsin population health Institute (2013) http://www.riverfallsjournal.com/content/pierce-among-wisconsins-healthiest- counties#sthash.5BHAprIq.dpuf Pierce County Wisconsin (2013) public health http://www.co.pierce.wi.us/Public%20Health/Environmental_Health.html E Podunk (2013) the power of place http://www.epodunk.com/top10/countyPop/coPop50.html Wisconsin department of health services (2012) http://www.dhs.wisconsin.gov/stats/0911life.htm Wisconsin Epidemiological Profile on alcohol and other drug use (2008). http://www.dhs.wisconsin.gov/stats/pdf/alcoholconsumption2008.pdf American Civil Liberties Union(2013) http://www.aclu.org/files/assets/aclu-thewaronmarijuana-rel2.pdf Behm, D,( 1989), Ill Waters: The Fouling of Wisconsin's Lakes and Streams (Special Report), The Milwaukee Journal, p. 2. http://www.gjournals.org/GJEPH/GJEPH%20PDF/2013/April/Eltigani%20and%20Abdallaziz.pdf

The greener Journal of Epideminology and public health(1998)

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